Management of patients with clinically suspected pyelonephritis in a resource poor setting

Background: This study aimed to determine the aetiology, antimicrobial susceptibility pattern and the clinical response to antibiotics in pyelonephritis.

Methods: Bacterial culture and ABST, clinical response and onset of renal failure were analyzed in 240 clinically suspected pyelonephritis patients admitted to Medical Units at Base Hospital, Tangalle.

Results: Of the 240 patients 61% had culture positive UTI mainly due to E. Coli (94%). Pathogens were 100% sensitive to meropenem, imipenem and amikacin while it showed 96%, 93%, 85%, 81%, 60%, 36%, 13% sensitivity for nitrofurantoin netilmicin, gentamicin, co amoxiclav, ceftriaxone, ciprofloxacin and ampicillin. The average duration of fever in days after administration of IV antibiotic was: gentamicin 1.66, co amoxiclav 1.98, ceftriaxone 2.14, and ciprofloxacin 2.34.

Conclusion: Gentamicin was the most clinically effective antibiotic from the antibiotics used for the treatment of pyelonephritis in the selected patient population.